North Bay House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last inspection we rated this key question Requires Improvement. At this assessment the rating has remained the same. This meant people’s needs were not always met.

At the previous inspection the provider was in breach of the legal regulation relating to Person centred care. Although some improvements were noted, the provider remained in breach of this regulation.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. People’s care plans were not always detailed to demonstrate how person-centred care was being delivered in line with people’s personalised preferences and needs. Staff met people’s individual needs relating to their direct, day-to-day support with personal care, eating and drinking and some activities. However, staff did not always support people to develop their individual skills, to identify goals, aspirations and to work towards them. The registered manager was developing this area and was aware improvements were needed. This area of people’s care will also be progressed with the support of the activity co-ordinators, who had good ideas about how they would do this.

People’s care plans did not always contain specific risk assessments relating to skin integrity or mental health risks. Some care plans were lacking detail about how people’s risks were being met, and the support they needed. Some people’s care plans contained information about their cultural or spiritual background. However, there was limited guidance about how staff should support people to maintain these needs.

Some observations we made did not support person-centred interactions, such as staff being dismissive of a person who was crying, a person being moved in a wheelchair without first gaining consent, and on another occasion, there was no interaction when a person was being moved with a hoist by staff. The person was therefore not given assurances during the manoeuvre so they felt at ease and knew what was happening.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Some new staff had joined the service, but there was also a regular staff team offering consistency of care so people were familiar with the staff providing their care. People could access GP's, chiropodists, district nurses, SALT (Speech and Language Therapist) and other professionals when referrals were made. Some improvements were needed to ensure records consistently included the outcome of referrals to other professionals and the guidance provided.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s care records contained information on how to communicate with them. During our visit we observed staff communicating with people. There was some pictorial and written information for people around the home. This included information about staff on duty, activities, and menus. We did however find that some confidential information about people’s care needs was stored in an accessible area in the dining room. Relatives mostly felt information was shared as needed. One relative said, “It is better in some ways, but I can’t remember if I have seen [relatives] care plan.” Another relative told us, “There seems to be a sticker system (red, blue and yellow circles) on the bedroom doors which obviously tell the staff something, but I would like to have it explained to me.” Several relatives knew of the changes required in the service, many of whom told us they had noticed the improvements. Some told us they would like more information on what changes exactly had been made to enhance the care people received. One relative thought a regular update from the provider would be helpful in relation to this.

The provider mostly ensured that people were able to share feedback and ideas, or raise complaints about their care, treatment and support. Most relatives we spoke with felt they would be listened to if they raised complaints and actions would be taken. Some relatives felt communication could be better. One relative told us, “I would consider myself reasonably informed about [relatives] health and well-being, but communication isn’t the best. More detail about [relatives] mental well-being would be appreciated. I have given feedback before but have not been told of any actions or outcomes as a result.” Another said, “Overall, I think senior communications could be better. They need to move on now and keep family informed of everything that has changed as a result.”

People and relatives were provided with feedback surveys which we reviewed. Whilst these were mostly positive, some had fed back certain concerns where they thought things could be better, however, we did not see an action plan had been devised by management to ensure feedback was acted on within a reasonable timeframe.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People were supported to access regular health appointments to ensure that appropriate specialist advice was in place, including in response to people’s health needs deteriorating. The service was accessible to people, and people were provided with equipment to promote their access to all areas of the service and the community. People had equal access to the shared environment which was accessible to them.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Care plans showed the provider had considered people’s protected characteristics, such as disability and people who were living with dementia. They ensured when 1 person’s mental health was deteriorating that they had access to specialist teams. Staff received equality, diversity and human rights training.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Staff received end of life training to ensure they were equipped with the skills to deal with this area of people’s care. One relative told us, “I want it on record that North Bay House were exemplary in their handling of my [relative’s] final weeks and my [family members] desire to spend as much time with [relative] as they could. They worked with the end-of-life team and made sure [relative] had [medication] in place to keep them comfortable.” Care plans contained a section on people’s wishes for their end-of-life care.